Reviews in Clinical MedicineReviews in Clinical Medicinehttp://rcm.mums.ac.ir/
Wed, 15 Aug 2018 03:26:31 +0100FeedCreatorReviews in Clinical Medicinehttp://rcm.mums.ac.ir/
Feed provided by Reviews in Clinical Medicine. Click to visit.Relationship between heart failure with preserved ejection fraction and thyroid disorders: ...http://rcm.mums.ac.ir/article_6471_0.html
Introduction: Heart failure with preserved ejection fraction may be combined with some other disease or as a result of dysfunction in their normal performance. Thyroid dysfunctions and abnormal thyroid hormone levels may be in close relation with heart problems, and may be indicators of future heart failure.
Methods: Scopus and PubMed were searched methodically using "thyroid disorders" and "heart failure with preserved ejection fraction" as search terms on April 2015 to find articles with English language in which the association between thyroid disorders and heart failure with preserved ejection fraction (HFPEF) had been evaluated. Full text of all relevant articles was comprehensively reviewed and used for data extraction.
Results: Of total 51 articles found in PubMed, 34 records found in Scopus and 3 articles found through reference list screening, only 13 papers fully met the inclusion criteria for further assessment. A total of 2135 patients participated in the included literatures, 1450 were male and 595 were female.
Discussion: Results of studies show that cardiac and thyroid functions are in close relationship, in which the level of thyroid hormone, predominantly T3 level can be considered as an independent prognostic factor in HFPEF. Moreover, findings suggested that thyroid hormones level can be considered as predictors for mortality due to HF.
Conclusion: Based on the results obtained in the included documents, there may be association between thyroid disorders and thyroid hormone levels with cardiac complications, particularly heart failure with preserved ejection fraction.Sat, 20 Feb 2016 20:30:00 +0100Iranian Medicinal Plants and Intractable Epilepsy in Childhood: A Narrative Reviewhttp://rcm.mums.ac.ir/article_8229_1343.html
Epilepsy is a major neurological disorder, which may occur in all age groups, including children. Approximately 20% of epileptic children are drug-resistant. Uncontrolled seizures pose variable risks to patients, such as increased mortality rate, trauma, and cognitive and psychiatric disorders. Therefore, effective treatment is essential to controlling seizure attacks. Although many antiepileptic drugs are currently available for clinical treatments, clinicians are concerned with the discovery of safer drugs with enhanced antiepileptic effects and fewer side-effects. Traditional medicine provides strong grounds for modern medicine. Use of some medicinal plants has been shown to reduce or prevent the further progression of epileptic seizures. The present review aimed to discuss the effectiveness of some medicinal plants in the treatment of children with intractable epilepsy. An online literature review was conducted in databases such as IranMedex, Scopus, Medline, and Google Scholar to identify the studies investigating the use of medicinal plants in children with intractable epilepsy. In addition, the files of the authors were reviewed in the reference lists and bibliographies of the retrieved articles. According to the results, herbal therapies could potentially yield new treatment options for children with intractable epilepsy. Using medicinal herbs could be a cost-efficient treatment method in these patients as a culturally acceptable option to their families.Thu, 31 May 2018 19:30:00 +0100Thalamus tumor prognosis; systematic reviewhttp://rcm.mums.ac.ir/article_6475_0.html
Introduction: Thalamic tumors can occur in all aging groups, however the children and adolescents are reported as the high risk aging groups. In this systematic review we aimed to investigate the prognosis of thalamic tumors with various histology and different aging groups.
Methods: PubMed was searched for English language articles that studied the prognosis of patients with thalamic lesions regarding the survival and mortality of patients. Inclusion criteria were all the cohort and retrospective studies that included only patients with thalamus tumors. Articles that studied involvement of other parts despite the thalamus or those that included patients with secondary thalamus tumors were excluded.
Results: totally 15 articles were included in this systematic review. The prognosis value of tumor histology, extend of resection, and patients&rsquo; age is extracted from the included articles. Results are presented as survival duration and overall survival rate of patients.
Discussion: Although thalamic tumors are difficult to be operated, it is possible to be resected without mortality and morbidity. Factors including histological type of tumor, extent of resection, and presenting age can affect the prognosis of the thalamic tumors.
Conclusion: The prognosis of thalamus tumors is mainly related to tumor type. Benign thalamic tumors have shown favorable outcome regarding the survival duration.Sat, 20 Feb 2016 20:30:00 +0100Prognosis of Epilepsies and Epileptic Syndromes in Children: A Narrative Reviewhttp://rcm.mums.ac.ir/article_8340_1343.html
Epilepsies and epileptic syndromes are among the most common chronic neurological disorders in neonates, infants, and children. Remission occurs in 70% of epileptic children, while other cases experience frequent seizures and become refractory to various treatment modalities. Refractory seizures have a significant adverse impact on the quality of life of epileptic children and their families. Prognosis of epilepsies is determined based on the risk of seizure or convulsion recurrence. Some of the most important risk factors for recurrence are the age at seizure presentation, neurodevelopment of the child, etiology of seizures, seizure frequency before anticonvulsant withdrawal, response to antiepileptic medications, type of epileptic syndromes, and electroencephalography of the patient. Recognition of the risk factors for seizure recurrence results in the optimal management of the treatment protocols, thereby reducing the adverse effects of epileptic seizures on patients and their families. The present study aimed to provide a narrative review of the most important risk factors for the recurrence of epilepsies in children by two child neurologists.Thu, 31 May 2018 19:30:00 +0100Assessment of brain activity changes in patients with former heroin dependency under methadone ...http://rcm.mums.ac.ir/article_7621_0.html
Introduction: Functional magnetic resonance imaging (FMRI) has been successful in illustrating the brain function of patients addicted to different drugs. Methadone maintenance is proposed as the standard agonist substitution treatment for opiate dependent patients. In this study we aimed to systematically review all the MRI findings related to former heroin addicts under long term methadone maintenance therapy. Method: PubMed was performed by the following search strategy: (methadone OR Dolophine) AND (MRI OR magnetic resonance imaging), with no language and date restrictions. Results: Out of 56 articles found at the initial search, 5 articles were eligible to be included in the systematic review, which were published from 2008 &ndash; 2014. In all the included studies the effect of long term MTT in confronting with drug related cues was compared with healthy control individuals or neutral stimuli. One article studied the acute efficacy of methadone use and one article compared the effect of different durations of MTT on brain responses to drug related cues. Conclusion: Different brain parts from prefrontal to deep limbic structures have been activated by drug related cues observation in patients under long term MMT. However methadone has shown the ability to inhibit the heroin craving and decreasing withdrawal symptoms, the learned brain response to drug stimuli persists despite long-term MMTFri, 30 Sep 2016 20:30:00 +0100Vitamin E and Autoimmune Diseases: A Narrative Reviewhttp://rcm.mums.ac.ir/article_10480_1343.html
Autoimmune diseases are characterized by the attack of the immune system to normal tissues. Patients with autoimmune diseases usually have the deficiency of dietary factors &nbsp;that may be related to the etiology of these conditions. Given the role of vitamin E as a physiologic stabilizer of lysosomal membranes, its deficiency can initiate the process of autoimmune diseases or accelerate its progress. It is supposed that vitamin E could reduce oxidative stress, which is an important factor in the pathogenesis of autoimmune diseases. The literature review is indicative of a decrease in the serum levels of vitamin E in almost all autoimmune diseases. Furthermore, there is evidence regarding the possible therapeutic value of vitamin E in the management of autoimmune diseases. Owing to the anti-inflammatory and protective effect of vitamin E against free radicals, and also its important effect on cytokines levels, this vitamin may play a powerful role in the prevention and treatment of rheumatoid arthritis, as well as joint inflammation and damage. Moreover, increased vitamin E intake might decrease the incidence and severity of certain autoimmune diseases through the regulation of the immune system.Thu, 31 May 2018 19:30:00 +0100SOX6 expression level in brain tumorshttp://rcm.mums.ac.ir/article_8233_0.html
Abstract Introduction: Due to the importance of SOX6 expression in brain tumors as a promising diagnostic and therapeutic target, we tried to systematically review existed information regarding the expression pattern of this CT gene in human normal and cancerous brain tissues. Method: PubMed was searched with the following search strategy: (SOX 6 OR SOX6 OR SOX-6) AND tumor, on Oct-2015. All types of articles, which studied the quantitative aspect or the intensity of the expression of the SOX6 in patients with different types of brain tumors, were included in this systematic review. There was not restriction regarding the date of publication or the language of the obtained articles. Results: Totally, 125 articles were obtained following the initial search in PubMed. Majority of the obtained articles were irrelevant with the aim of the study due to investigating other types of tumors except brain tumors. Eventually 5 articles were completely eligible to be involved. Discussion: Based on presented articles results, glioma tissue cells shows genes expression pattern compatible and well matched with developing CNS cells. Regarding the relation of SOX6 in oncogenesis, it seems that SOX6 does not stimulate proliferation however affect the early stage of oncogenesis in gliomas by inducing transformation activity. Conclusion: High rate of SOX6 expression made it a considerable choice as a therapeutic and diagnostic marker; however more accurate information on the protein expression pattern is essentialMon, 30 Jan 2017 20:30:00 +0100General Principles of the Medical Management of Epilepsy in Children: A Literature Reviewhttp://rcm.mums.ac.ir/article_9001_1343.html
The primary aim of epilepsy treatment is seizure control, and the treatment is principally prophylactic. Although complete seizure control is the most important predictor of improved quality of life, antiepileptic drugs (AEDs) could cause severe side effects in the patients. Therefore, the risk-benefit ratio must be considered before the initiation of AED treatment. Accurate recognition and differentiation of epileptic and non-epileptic paroxysmal events and the diagnosis of the seizure type and epilepsy syndrome are essential procedures before AED treatment. It is often recommended that AED treatment start after two seizures, and being seizure-free for a minimum of two years is a prerequisite for treatment withdrawal. The AED treatment process must be initiated with a single drug at a low maintenance dose, along with further upward titration. Overall, the first attempt in AED treatment has been reported to effectively control seizures in 50-70% of the cases. Moreover, there is a consensus that being seizure-free for two years is the most valid approach to discontinue AED treatment. Approximately 50% of the children with epilepsy outgrow their disease. The present study aimed to provide a systematic method for the treatment and management of epilepsy in children.Thu, 31 May 2018 19:30:00 +0100Therapeutic updates for Lichen planopilaris and Frontal fibrosing alopecia: a systematic reviewhttp://rcm.mums.ac.ir/article_10481_0.html
Background: Lichen planopilaris (LPP) and frontal fibrosing alopecia&nbsp;(FFA) are skin diseases. A systematic review about LPP and FFA treatment was published in 2013 but further updates are needed. Objectives: the aim of our study is to systematically review the studies that published after the publication of the last systematic review. Method: We searched in Scopus, Pubmed, Embase, and ISI web. All studies from March 2012 to Jun 2017 were included. Study selection and extraction were separately done by two reviewers. Studies should report a treatment and treatment outcome to fulfill the inclusion criteria. The outcomes of the studies were categorized as unimproved, stabilization, and improvement based on articles reports. Result: Of 38 studies, twenty studies assessed LPP treatment, seventeen FFA treatment and one study assessed both. Studies were case-report case series, cohort, and RCTs. Antimalarial agents and pioglitazone showed improvement in 73 % and 71% of LPP patients respectively. Improvement and stabilization was seen in about one third of the topical steroid users and 6/12 of Tacrolimus/pimecrolimus users in LPP. Improvement and stabilization in FFA was found in 68% of antimalarial agent users, 83% of intralesional steroid users, all cases of finasteride users, and 95% of dutasteride users. Conclusion: in contrast with the previous systematic review, we found that antimalarial agents may be more effective than steroids in LPP. Finasteride/dutasteride may have good effects in FFA. Intralesional steroids showed to be more effective than antimalarial agents in FFA. Still further studies are needed to define a treatment protocol. Making a conclusion based on low quality and heterogeneous articles limited our study.Mon, 12 Mar 2018 20:30:00 +0100Cell-based Treatments of Femoral Head Osteonecrosis: A Literature Reviewhttp://rcm.mums.ac.ir/article_11124_1343.html
The preferred desire of orthopedic surgeons is to preserve the femoral head in the early stages of femoral head osteonecrosis; however, hip arthroplasty is needed in most cases. The outcomes of traditional surgical treatments alone are not favorable. Thus, femoral head osteonecrosis frequently follows an unpredictable course resulting in significant hip arthritis. Through the years, it has been identified that decreased proliferation capacity and content of bone marrow stem cells (BMSCs) in the femoral head region play a key role in the pathogenesis of osteonecrosis of femoral head (ONFH). In the past two decades, researchers have focused on cell-based therapies for ONFH treatment. The regenerative potential of damaged cartilage and bone tissue with stem cells has become a new treatment approach in the field of orthopedics. Ongoing basic science and clinical studies are progressing toward efficient standard treatment options for this extremely challenging condition. In this article, we reviewed the recently developed methods of cell therapy for these types of musculoskeletal conditions.Thu, 31 May 2018 19:30:00 +0100Food recommender systems for diabetic patients: a Narrative reviewhttp://rcm.mums.ac.ir/article_7488_0.html
WHO estimates that the&nbsp;number&nbsp;of&nbsp;people&nbsp;with&nbsp;diabetes will grow 114% by 2030.It declares that, patients have to play a major role to control and therapy of diabetes by being provided with updated knowledge about the disease and different aspects of available treatments, diet therapy in particular. In this regard, diets recommender Systems would be helpful. They are techniques and tools which suggest the best diets according to patient's health situation and preferences. Accordingly this narrative reviewed studies on the topic of food recommender systems and their features by focusing on nutrition and diabetic issues. Literature searches whit Google scholar and Pubmed were conducted during June and October 2014 and February 2015. Results&nbsp;were&nbsp;limited to&nbsp;papers in English and no limits were&nbsp;applied for the published year. &nbsp;We recognize three common methods for food recommender system: collaborative filtering recommender system (CFRS), knowledge based recommender system (KBRS) and context-aware recommender system (CARS). Also wellness recommender systems are a subfield of food recommender systems which help users to find and adapt suitable personalized wellness treatments based on their individual needs. &nbsp;Food recommender systems often used artificial intelligence and semantic web techniques. Some used the combination of both techniquesSat, 03 Sep 2016 19:30:00 +0100The Most Common Treatable Neurometabolic Epilepsies in Childrenhttp://rcm.mums.ac.ir/article_8178_1343.html
Epilepsy is a common neurological disorder in childhood with prominent neurological manifestations, signs, and symptoms in inherited neurometabolic disorders. Accurate diagnosis of neurometabolic disorders in epileptic patients increases the possibility of a specific treatment to improve epilepsy. Therefore, early diagnosis is essential in potentially treatable epileptic disorders. Various seizure types occur in neurometabolic disorders, which are often refractory to antiepileptic drugs (without the treatment of the underlying neurometabolic disorders). Patients with underlying disorders have severe clinical presentations, such as refractory seizures. In addition, they do not respond to antiepileptic drugs in many cases. In the epileptic patients with developmental delay and/or regression, neurometabolic disorders should be considered in the presence of abnormal neurological examination and brain imaging with specific patterns. Some of these disorders are potentially treatable. Therefore, neurologists should determine the etiology of epilepsy, especially in pediatric patients, and the treatment should not be restricted to symptomatic therapy. The present study aimed to introduce some of the treatable causes of epilepsy in pediatric patients.Thu, 31 May 2018 19:30:00 +0100Churg-Strauss Syndrome in a Seven-year-old Boy: A Case Reporthttp://rcm.mums.ac.ir/article_9087_1343.html
Churg-Strauss syndrome (CSS) is a type of vasculitis of small-to-medium sized vessels. This syndrome is known by a history of bronchial asthma with systemic necrotizing vasculitis and peripheral blood hypereosinophilia. It is currently called eosinophilic granulomatosis with polyangiitis (EGPA). This disease affects both genders and all age groups, but it is very rare among children. CSS diagnosis is based on clinical findings such as asthma, eosinophilia, rhinosinusitis, and signs of vasculitis in major organs. In cases where steroids alone or in combination with other immunosuppressive agents are used as treatment, the outcome and long-term survival are usually satisfying. In comparison with other types of systemic vasculitis, the mortality rate of this syndrome is low. In this study, we present the case of a 7-year-old boy with poorly controlled bronchial asthma since three years of age. This case had developed purpuric skin lesions, sinusitis, arthritis, and weakness of the limbs with symptoms of mononeuritis multiplex at the age of seven. After being admitted to our hospital, a series of studies, including complete blood count-diff, chest X-ray, paranasal sinus radiography, brain magnetic resonance imaging, nerve conduction study, spirometry, and serological tests for autoantibodies, were performed and he was diagnosed with CSS. Thereafter, he received regular corticosteroid therapy in combination with methotrexate, and his symptoms were generally well-controlled with the beginning of the treatment. The clinical characteristics, diagnosis, and management of CSS in children are also reviewed in this study.&nbsp;Thu, 31 May 2018 19:30:00 +0100Multiple Intracranial Meningioma in a Woman with Headachehttp://rcm.mums.ac.ir/article_11126_1343.html
Meningioma is one of the most common primary brain tumors in adults. The literature indicates a higher prevalence of multiple meningiomas in women, which might be attributed to the hormonal factors, such as expression of progesterone receptor.Here we report a 58-year-old woman with a 4-year history of headache, which was aggravated during the few months before her admission. The patient was diagnosed with multiple meningiomas based on her brain magnetic resonance imaging. Therefore, she underwent surgical excision of the tumor and had no complications or signs of recurrence in the site of surgery, after a 3-year follow-up.Although multiple meningioma is not frequent, it does not differ from solitary tumors in terms of prognosis and management. Our experience shows that complete removal of the tumors is not possible in all cases of multiple meningioma and resection of the largest tumors results in favorable outcomes.Thu, 31 May 2018 19:30:00 +0100